Jeddah: Dr. Abdul Hafeez Jahja Khoja
Today, more than 25 million people worldwide suffer from dementia, most of whom have Alzheimer’s disease affecting affected individuals, caregivers and the community.
Apart from advanced age and genetic susceptibility, the causative factors of the disease have not yet been identified. However, growing evidence strongly suggests potential risk roles for vascular risk factors and disorders (e.g., smoking, hypertension, middle-aged obesity, diabetes, and cerebrovascular lesions), as well as potentially useful for psychosocial factors (including: higher education, active social participation, physical exercise and stimulating mental activity) in facilitating the pathological process and clinical manifestations of dementia disorders.
Long-term, multidisciplinary interventions toward optimal control of risk factors, maintaining socially integrated lifestyles, and stimulating mental activities are expected to reduce risks or delay the clinical onset of dementia, including Alzheimer’s disease, according to the U.S. National Center for Dermatology. Alzheimer’s. Biological Information (National Center for Biotechnological Information).
Dementia can be defined as a clinical syndrome characterized by a range of symptoms and signs that manifest with memory difficulties, language disturbances and other cognitive functions, behavioral changes, and impairments in activities of daily living.
Alzheimer’s disease is the most common cause of dementia, accounting for up to 75 percent of all dementia cases, a progressive neurodegenerative disorder.
In recent decades, research on the epidemiology of dementia and Alzheimer’s disease has made tremendous progress.
– Alzheimer’s disease “
Symptoms and Causes: Alzheimer’s disease is characterized by a progressive cognitive decline that usually begins with a poor ability to form last memories, followed by the onset of all intellectual functions, and leads to complete dependence on the basic functions of daily life. and early death.
Distinctive neuropathological features of Alzheimer’s disease include the proliferation of extracellular amyloid plaques in the brain, often surrounded by neurofibrillary tangles within neurons, accompanied by reactive microscopy, neurodegeneration, and loss of neurons and synapses. While these pathological lesions do not fully explain the clinical features of the disease, it has been hypothesized that changes in beta-amyloid protein production and processing may be the underlying factor.
The reasons behind these multifaceted changes are still unknown, but advanced age and previous genetic and non-genetic factors are believed to play important roles. As both developed and developing countries are aging rapidly, the frequency is expected to double every 20 years until at least 2040. It is expected that, due to the aging of society worldwide, the number of individuals will also increase. at risk, especially in the elderly. It will be a costly public health burden in the years to come.
Risk factors: Alzheimer’s dementia is a multifactorial disease. Age is the strongest risk factor, suggesting that biological processes associated with aging may be involved in causing the disease. Furthermore, the strong association of Alzheimer’s disease with aging may partly reflect the cumulative effect of various risk and protective factors throughout life, including the impact of complex interactions of genetic susceptibility, psychosocial factors, biological factors, and environmental exposures throughout life. Whereas, data on the etiological role of other factors (eg: dietary factors, occupational exposure, infections) are mixed or insufficient.
Recent research and studies
A biomarker for predicting dementia: Emer McGrath, Professor of Medicine at the National University of Ireland in Galway, and colleagues measured the levels of biomarker (P-tau181) in the blood, a marker of neurodegeneration, in the 52 healthy perceptual adults they had were part of the US-based Framingham Heart Study, which later did positron emission tomography (PET) brain scans. Blood samples were taken from people without cognitive symptoms, who underwent a cognitively normal test at the time of the blood test.
The analysis revealed that higher levels of the P-tau181 biomarker in the blood were associated with increased ß-amyloid accumulation in specialized brain scans.
These tests were performed on average 7 years after the blood test. Additional analysis showed that this biomarker (P-tau181) outperformed others in predicting beta-amyloid markers in brain scans.
Professor McGrath said: “The results of this study are very promising, as the index (P-tau181) has the ability to help us identify individuals at risk of developing dementia at a very early stage of the disease, before they develop memory difficulties. or changes in behavior.
The research team suggested the possibility of developing a population screening program to determine the levels of this biomarker for them, as a means of control across the population to predict the risk of developing dementia in middle-aged or late individuals, or even earlier.
This research also has important potential implications in the context of clinical trials. P-tau181 blood levels can be used to identify eligible participants for further research, including clinical trials of new treatments for dementia. We can also use this biomarker to identify people who are at risk of developing dementia but who are still at a very early stage of the disease; Where there is still opportunity to prevent disease progression.
Expected Immunization Against Alzheimer’s Disease: Researchers at the University of Kansas, during experiments performed on animal models, discovered a possible new approach to immunization against Alzheimer’s disease. In it they used a protein rich in recombinant methionine (Met) which was then oxidized in the laboratory to produce the antigen: methionine sulfoxide (MetO) rich protein; According to ScienceDaily on May 3, 2022.
This antigen, when injected into the body, stimulates the immune system to produce antibodies against the MetO component of beta-amyloid, which is seen as a hallmark of Alzheimer’s disease as a protein that is toxic to brain cells. The results have just been published in the journal Antioxidants (Antioxidants, 2022; 11-4).
In this new study, lead investigator Jacob Moskovitz, assistant professor of pharmacology and toxicology at the University of Kansas School of Pharmacy, and colleagues injected MetO-rich protein into 4-month-old mice that had been genetically modified to develop familial form. of Alzheimer’s disease. Subsequent tests showed that this approach stimulated the immune system of mice to produce antibodies that could alleviate the phenotypes of Alzheimer’s disease at an older age (10-month-old mice); Where this treatment led to the production of anti-MetO antibodies in the blood plasma, which have a high titer for at least up to 10 months.
In a series of tests, University of Carolina researchers assessed the memory of mice injected against similar mice that did not receive methionine sulfoxide. There was a approximately 50 percent improvement in memory of mice injected with methionine sulfoxide (MetO) protein versus the control group.
Women respond faster to means to reduce the risk of Alzheimer’s disease: After age, sex is the most risk factor for Alzheimer’s disease, as two-thirds of Alzheimer’s patients are female. In fact, even when calculating gender-related mortality rates, age of death, and age differences, women are still twice as likely to be affected.
The study, led by Dr. Richard S. Isaacson of Florida Atlantic University, a leading neurologist and researcher, is the first of its kind to examine whether gender significantly affects cognitive outcomes in people who individually attend multidisciplinary clinical interventions. The study also determined whether the change in cardiovascular disease and Alzheimer’s disease risk, along with blood indicators of Alzheimer’s risk, was also affected by sex.
The results of the study, which was published in the Journal of Prevention of Alzheimer’s Disease on April 26, showed that risk-reduction care at an Alzheimer’s prevention clinic improved cognition in every patient, of women and men who do not have gender differences. However, in the prevention group, women showed greater improvements in a multiethnic study of atherosclerosis risk outcome than men.
Women in the early treatment group also showed greater improvements in cardiovascular disease risk factors, aging, and the incidence of dementia. Risk score calculates the risk of dementia in late life, based on middle-aged vascular risk factors such as body mass index, blood pressure, cholesterol, smoking status, and risk of cardiovascular disease over the next 10 years, using traditional risk factors.
Covid-19 pneumonia increases risk of developing dementia: A new study from the University of Missouri College of Medicine found that patients sleeping with Covid-19 pneumonia are at greater risk of developing dementia than they are with other types of pneumonia. .
A team of researchers led by Adnan I. Qureshi, MD, Professor of Clinical Neuroscience at the University of Missouri School of Medicine and colleagues, studied hospitalized patients with pneumonia for more than 24 hours. Results, published April 19, 2022 in the Infectious Diseases Forum, 2022; 9-4, showed that out of 10,403 patients with COVID-19 pneumonia, 312 (3 percent) developed new dementia after recovery, compared with 263 (2.5 percent) of patients with other types of pneumonia diagnosed with dementia.
The new type of dementia affects survivors of Corona infection mainly in memory, ability to perform daily tasks and self-regulation, and language and time and place awareness have remained relatively preserved.
Half of the elderly die with a diagnosis of dementia: A new study, published on April 1, 2022 in JAMA, led by Dr. listed dementia in their medical records, a 36 percent increase over two decades ago. This sharp increase may have more to do with better public awareness, more detailed medical records and Medicare billing practices, than an actual increase in the situation. The researchers used data from 3.5 million people over the age of 67 who died between 2004 and 2017, a period during which the National Alzheimer’s Disease Plan went into effect and hospitals, nursing homes and doctors’ offices were allowed to bill more diagnoses. including signs. of dementia. In 2004, about 35 percent of billing claims contained at least one indicator of insanity, and by 2017, that percentage had risen to more than 47 percent. Even when researchers limited it to patients who had at least two medical claims for dementia.
This resulted in a focus on public awareness of dementia, the quality of care provided and more support for patients and their caregivers. It was noted that this also provided an opportunity for more seniors to talk in advance with their families and health care providers about the kind of end-of-life care they would want if they had Alzheimer’s disease or some other form. of cognitive decline.
Community medicine consultant